Elsevier

Addictive Behaviors

Volume 25, Issue 4, July–August 2000, Pages 523-538
Addictive Behaviors

On quitting smoking: Development of two scales measuring the use of self-change strategies in current and former smokers (Scs-cs and scs-fs)

https://doi.org/10.1016/S0306-4603(00)00068-XGet rights and content

Abstract

Smoking-cessation advice may be more effective and acceptable if it is based on strategies used by people who quit smoking on their own. The objective of this study was to identify these self-change strategies and to develop and validate questionnaires measuring the frequency of their use in current and former smokers. Development of questionnaire items was based on qualitative data provided by 120 current and former smokers, and the validation study was conducted by mail in 638 smokers and ex-smokers in Geneva, Switzerland, from 1996 to 1998. We identified 5 distinct and interpretable self-change strategies in current smokers and 5 strategies in former smokers, and measured their frequency of use with a 19-item questionnaire in current smoker (SCS-CS) and with a 17 item questionnaire in former smokers (SCS-FS). Eight items and 2 strategies were common to both current and former smokers. the scales fulfilled criteria of test-retest reliability, and content, construct, and predictive validity. Participants who quit smoking between the baseline survey and the 1-month follow-up had higher baseline scores for all self-change strategies (+0.65 to +1.16 standard deviation units) than participants who remained smokers at follow-up. These scales may be used to describe and understand the processes of smoking cessation and relapse, as well as to produce input data for computer systems which produce individually-tailored smoking cessation advice.

Section snippets

Qualitative survey

We used a systematic approach to scale development Jackson 1970, Streiner & Norman 1995. We began by conducting a mail survey of current and former smokers to collect qualitative data on self-change strategies. Participants were recruited among persons who had already participated in previous smoking-related surveys (Etter, Perneger, & Ronchi, 1997), and were either members of the University of Geneva (students and staff) or residents of Geneva, Switzerland. The questionnaire was mailed once to

Qualitative survey

The 120 participants in the qualitative survey were on average 34 years old, 68% were women, and 68% were current smokers. Participants wrote 710 interpretable statements on activities, thoughts, and events that are used or occur in the transitions between the various stages of change (Table 3). All statements were attributed to one of the “processes of change” identified by Prochaska, and to an additional category called “Events that cause change.” These statements formed the basis of the

Discussion

In this study, we identified eight distinct and interpretable self-change strategies that smokers and ex-smokers use to progress from the stage where they have no intention to quit smoking to the long-term maintenance of abstinence. Furthermore, we developed and validated two scales (SCS-CS and SCS-FS) measuring the frequency of use of these strategies in current and former smokers. The identification of these self-change strategies and the development of scales to measure them will be useful

Acknowledgements

This research was supported by grants from the Swiss National Science Foundation to J.F. Etter (32-47122-96, 3233-054994.98 and 3200-055141.98), by the Swiss Cancer League, the Swiss Federal Office of Public Health, Health Authorities of the Cantons of Geneva and Jura, the Geneva Cancer League, and the Swiss Foundation for Health Promotion.

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